Design and evaluation of a coalition-led obesity initiative to promote healthy eating and physical activity in low-income, ethnically diverse communities: the Go! Austin/Vamos! Austin initiative

Abstract

Background Go! Austin/Vamos! Austin (GAVA) is a coalition-led health initiative that targets low-income communities with disparities in access to healthy food and physical activity . The purpose of this initiative was to increase healthy eating and physical activity among residents by facilitating access to food and physical activity opportunities through environmental and policy changes. Although GAVA is ongoing, this paper describes the original GAVA intervention and the 5-year evaluation study (2013–2018), presenting selected baseline data obtained through its cohort sub-study. Methods To assess the impact of GAVA, the evaluation plan included multiple sub-studies and involved collection of quantitative, qualitative, and observational data at different levels. The main cohort sub-study followed 313 parent-child dyads over 5 years. Annually, parents completed self-administered surveys regarding awareness and use of community assets/resources as well as their diet and activities. Heights and weights also were measured. Results Cohort participants were primarily Hispanic (87%), very low-income (77%), and food insecure (58%), with high overweight/obesity prevalence among both parents (81%) and children (41%). Awareness and use of community physical activity and healthy eating resources were low, and reported barriers to using these resources were many. Engagement in physical activity and healthy eating also was low. Conclusions Given the baseline statistics, GAVA resident teams chose and implemented strategies to address the noted barriers and low usage of community resources. This approach built community capacity and governance. Both the GAVA intervention approach and evaluation protocol can serve as models for other community initiatives to be implemented in other locations and contexts.

Characterizing Micro-scale Disparities in Childhood Obesity: Examining the Influence of Multilevel Factors on 4-Year Changes in BMI, Healthy Eating, and Physical Activity, Among a Cohort of Children Residing in Disadvantaged Urban Enclaves

“…Vamos Austin! Evaluation (GAVA) Evaluation Study , obtained from residents of selected zip codes located in Austin's Eastern Crescent (23). The Eastern Crescent of Austin is predominantly Hispanic (and mostly populated by people of Mexican origin or descent), with several of the zip codes in the bottom 10 percent of all zip codes in Texas when classified by income.…”

“…Extensive information on the design, sampling, and data collection of the parent study is available elsewhere (23). Briefly, the parent study that evaluated GAVA recruited and followed a cohort of 313 child-caregiver dyads, consisting of children enrolled in Kindergarten at baseline, and their self-identified primary adult caregivers.…”

“…Child BMI was derived using objectively measured weight and height, using fixed stadiometers and calibrated scales, with standardized measurement protocols administered by trained data collectors (26). More information on the measurement protocol is available elsewhere (23). For each child, computed BMI scores were used to determine their BMI percentile at each assessment time-point, using the Centers for Disease Control and Prevention sex- and age-specific BMI percentiles for children ages 2–20 years (27, 28).…”

“…In addition to examining baseline to follow-up change in BMI, we built analogous change variables to categorize child participants depending on whether they increased, decreased, or did not modify their weekly frequency of fruit and vegetable intake, and of participation in physical activity, respectively. Both of these secondary dependent variables were derived using questionnaire data from the parent GAVA Evaluation cohort study (23). In each assessment time point, primary caregivers responded to “How many days per week does your child eat five servings of fruit and vegetables?,” and “How many days per week is your child physically active at least 30 min?” For both items, response options included “less than 1 day per week,” “2–3 days per week,” “4–5 days per week,” and “more than 5 days per week,” and were scored to represent weekly frequency of these behaviors.…”

“…A series of baseline (2013) variables at multiple levels of the ecological model were included in this study as independent variables. All but one (parental BMI, which was derived from objectively measured height and weight) were based on the GAVA Evaluation baseline survey (self-reported instrument administered to primary caregivers) (23).…”